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Individual

JOANNA LUCIA BISSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, LCSW-C, LICSW

Contact information

Practice address
140 PROSPECT AVE STE U, KIRKWOOD, MO 63122-6024
(314) 690-5873
(314) 677-3326
Mailing address
140 PROSPECT AVE STE U, KIRKWOOD, MO 63122-6024
(314) 690-5873
(314) 677-3326

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2018039484
MO
1041C0700X
Clinical Social Worker
22628
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
490066029
MO
Enumeration date
04/18/2017
Last updated
06/11/2019
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